Vaccine shortfall leaves poorer countries at risk

April 30, 2009 11:49 IST

Manufacturers warned on Wednesday that limited stocks of a future swine flu vaccine could be distributed on a "first come, first served" basis, leaving hundreds of millions of people in poorer countries without protection.

Andrin Oswald from Novartis, one of the world's top flu vaccine producers, told the Financial Times his company had already allocated more than a fifth of its total capacity for making a future pandemic vaccine to governments, including the US and the UK.

His comments came as representatives of the vaccine industry met European health officials to prepare for an EU meeting on Thursday in Brussels to discuss their response to a pandemic, including how to allocate and pay for supplies.

With several months required to produce new vaccines, and total global manufacturing capacity far below the world's population, scarce supplies could be the source for political tensions between richer, well-prepared countries and the rest.

Planners have also raised concerns that a handful of European countries that dominate vaccine production - including France and Germany - could close their borders to restrict the export of vaccines until their own populations are covered.

"We are expecting the Commission to develop a strategy for allocation between countries," said Luc Hessel from Sanofi-Pasteur, the vaccines arm of Sanofi-Aventis of France and a board member of the European Vaccine Manufacturers' Association.

He said that about 15 countries - including Canada and the US, many in Europe, and Japan and Australia - had placed "advance contracts" for about 200m pandemic flu doses, representing half of current total annual production for seasonal flu vaccines of 400m.

However, he stressed that a range of new techniques could substantially boost productivity.

In the past few years, the vaccine industry has been working with the World Health Organisation and policymakers to devise ways to expand vaccine capacity.

By switching to a single "monovalent" dose rather than trivalent vaccines that protect against three different seasonal flu strains each year, productivity could be substantially enhanced.

Further gains could come from injecting just into the skin, which appears to boost efficacy, as well as the use of a chemical adjuvant to boost the body's immune response and allow "cross-protection" for strains other than the one for which the vaccine was specifically engineered.

Manufacturers and health officials are also wary of switching immediately from producing vaccines for the next seasonal flu outbreak while data on the impact of the H1N1 virus are limited.

However, these production cycles should be finished within a few weeks, giving time for them to consider whether to replace one of the three antigens in the next seasonal vaccine with the H1N1 strain identified in Mexico.

Vaccine makers have long argued that the best way to prepare for pandemic production is to boost seasonal vaccination, which allows capacity to be strengthened and switched to pandemic production when necessary.

Novartis said it would shortly release the results of tests showing the efficacy of its existing adjuvanted flu vaccine against H1N1.